EXCELSIOR INTEGRATED MEDICAL GROUP NPI 1275081838

NPI Information

NPI: 1275081838
Provider Name: EXCELSIOR INTEGRATED MEDICAL GROUP
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Organization

Specialization: Adult Health

Address:
217 GRAND ST
SUITE 401
NEW YORK, NY
ZIP 10013
Phone: (212) 390-1830
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EXCELSIOR INTEGRATED MEDICAL GROUP is an adult health nurse practitioner in New York, NY. EXCELSIOR INTEGRATED MEDICAL GROUP NPI is 1275081838. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

217 GRAND ST
SUITE 401
NEW YORK, NY
ZIP 10013-396
Phone: (212) 390-1830
Fax: (212) 390-8177

The provider's authorized official is Geogre Hall .
The authorized official title is President and has the following contact phone number (718) 938-3188.

The enumeration date for this NPI number is 9/13/2016 and was last updated on 9/13/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	9389049	NEW YORK	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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